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Assessing the Relationship between Anxiety and Revision Surgery following Autologous Breast Reconstruction.

Publication ,  Journal Article
Orr, JP; Sergesketter, AR; Shammas, RL; Thomas, AB; Cason, RW; Zhao, R; Broadwater, G; Hollenbeck, ST
Published in: Plastic and reconstructive surgery
July 2019

Revision procedures address contour irregularities and aesthetic concerns following autologous breast reconstruction. Mental health diagnoses are known to influence patient satisfaction with reconstruction. The authors aimed to identify oncologic, reconstructive, and demographic factors, including mental health diagnoses, associated with the number of revisions after autologous breast reconstruction.The medical records of all adult women undergoing abdominal free flap-based breast reconstruction at a major academic institution between 2011 and 2016 were reviewed. Multivariate logistic regression was used to identify factors associated with receipt of revisions. Negative binomial regression was used to identify characteristics associated with number of revisions received.Of 272 patients identified, 55.2 percent received one revision, 23.2 percent received two revisions, and 10.3 percent received three or more revisions after autologous breast reconstruction (median, one; range, zero to five). After adjustment on multivariate analysis, anxiety (OR, 4.34; p = 0.016) and bilateral reconstruction (OR, 3.10; p = 0.017) were associated with receipt of any revisions; other oncologic and reconstructive factors including breast cancer stage, receipt of radiation therapy, and type or timing of free flap reconstruction were not associated with revisions. Using univariate negative binomial regression, anxiety (incidence rate ratio, 1.34; p = 0.006), Caucasian race (incidence rate ratio, 1.24; p = 0.02), and bilateral reconstruction (incidence rate ratio, 1.39; p = 0.04) were predictive of increased numbers of revisions received. After stepwise selection on multivariate analysis, anxiety remained the only significant predictor of increased numbers of revisions.Preoperative anxiety significantly influences the number of revisions after autologous breast reconstruction. Further research is necessary to better understand the interplay among mental health, patient preference, and outcomes in breast reconstruction.Risk, III.

Duke Scholars

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Published In

Plastic and reconstructive surgery

DOI

EISSN

1529-4242

ISSN

0032-1052

Publication Date

July 2019

Volume

144

Issue

1

Start / End Page

24 / 33

Related Subject Headings

  • Transplantation, Autologous
  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Rectus Abdominis
  • Preoperative Care
  • Patient Satisfaction
  • Middle Aged
  • Mammaplasty
 

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Orr, J. P., Sergesketter, A. R., Shammas, R. L., Thomas, A. B., Cason, R. W., Zhao, R., … Hollenbeck, S. T. (2019). Assessing the Relationship between Anxiety and Revision Surgery following Autologous Breast Reconstruction. Plastic and Reconstructive Surgery, 144(1), 24–33. https://doi.org/10.1097/prs.0000000000005696
Orr, Jonah P., Amanda R. Sergesketter, Ronnie L. Shammas, Analise B. Thomas, Roger W. Cason, Ruya Zhao, Gloria Broadwater, and Scott T. Hollenbeck. “Assessing the Relationship between Anxiety and Revision Surgery following Autologous Breast Reconstruction.Plastic and Reconstructive Surgery 144, no. 1 (July 2019): 24–33. https://doi.org/10.1097/prs.0000000000005696.
Orr JP, Sergesketter AR, Shammas RL, Thomas AB, Cason RW, Zhao R, et al. Assessing the Relationship between Anxiety and Revision Surgery following Autologous Breast Reconstruction. Plastic and reconstructive surgery. 2019 Jul;144(1):24–33.
Orr, Jonah P., et al. “Assessing the Relationship between Anxiety and Revision Surgery following Autologous Breast Reconstruction.Plastic and Reconstructive Surgery, vol. 144, no. 1, July 2019, pp. 24–33. Epmc, doi:10.1097/prs.0000000000005696.
Orr JP, Sergesketter AR, Shammas RL, Thomas AB, Cason RW, Zhao R, Broadwater G, Hollenbeck ST. Assessing the Relationship between Anxiety and Revision Surgery following Autologous Breast Reconstruction. Plastic and reconstructive surgery. 2019 Jul;144(1):24–33.

Published In

Plastic and reconstructive surgery

DOI

EISSN

1529-4242

ISSN

0032-1052

Publication Date

July 2019

Volume

144

Issue

1

Start / End Page

24 / 33

Related Subject Headings

  • Transplantation, Autologous
  • Surgery
  • Risk Factors
  • Retrospective Studies
  • Reoperation
  • Rectus Abdominis
  • Preoperative Care
  • Patient Satisfaction
  • Middle Aged
  • Mammaplasty